Play TherapyPlay TherapyPlay TherapyPlay Therapy

Chapter 2-5Chapter 2-5

• Divide into groups of four and talk about your memories of playing.

Meaning of Play• Universal and inalienable right of

childhood• It is spontaneous, enjoyable,

voluntary, and nongoal-directed• Does not depend on external reward• Learn to live in symbolic world• Opportunity to “act out” situations

which are disturbing, conflicting and confusing

Play is a Language• Play is a child’s natural form of

expression• Adults talk/Children Play• Adults use words• Children use Toys

• Physically active• Allow imagination• Learn culture• Develop skills

Rationale of Play Therapy

“It is becoming increasingly clear through research on the brain as well as in other areas of study, that childhood needs play. Play acts as a forward feed mechanism into courageous, creative, rigorous thinking in adulthood.”

---Tina Bruce, ProfessorLondon Metropolitan

University

Symbolic Play• Piaget- play bridges gap between

concrete experience and abstract thought

• Attempt to organize experiences, feel control, feel secure

• Expression of inner world

Communication Through Play

• Therapist goes to the level of the child’s natural communication

• Feelings can be projected • Allows child to communicate

concretely

Play in Therapeutic Process

• Medium for expressing feelings, exploring relationships, and self fulfillment.

• Toys are used like words; play is the language

Play can reveal• What the child has experienced• Reactions to what was experienced• Feelings about what was

experienced• What the child wishes, wants and

needs• Child’s perception of self

• Child learns to accept limits• Child learns to make choices

Reasons for Treatment• temper tantrums• aggressive behavior• non-medical problems with

bowel or bladder control• difficulties with sleeping or

having nightmares• experiencing worries or

fears • children who have

experienced sexual or physical abuse, neglect, the loss of a family

• Children who are unable to control their attention or impulses

• Children who have a tendency to react with violence, or who experience severe anxiety

• Children with learning disorders

• to alleviate feelings of low self-esteem, excessive worry, helplessness, and incompetency

Stages (Moustakas)• Diffused negative feelings, expressed

everywhere• Ambivalent feelings, generally anxious or

hostile• Direct negative feelings, expressed toward

parents, siblings, and other, or regression• Ambivalent feelings, positive and negative,

toward parents, siblings and others• Clear, distinct, separate, realistic positive and

negative attitudes

Process (Hendricks)• Sessions 1-4 Curious, engaged in

exploratory, creative play• Sessions 5-8 Continued exploratory,

creative play. Expressions of aggression• Sessions 9-12 Exploratory,

noncommittal and aggressive play decreased, relationship play increased, nonverbal checking with therapist increased, more information

• Sessions 13-16 Creative and relationship ;play predominated, specific aggressive play increased.

• Sessions 17-20 Dramatic and role play predominated, increased relationship building with therapist.

• Sessions 21-24 Relationship play and dramatic and role play predominated, and incidental play increased.

Play of Adjusted vs. Maladjusted Children

• Maladjusted- very quiet, no spontaneous conversation, or too much talking. May be cautious and deliberate

• Adjusted- play freely, look at many of the toys

Maladjusted:

• May wait to be told what to do • Express feelings symbolically• Aggressive and destructive• Express negative feelings more often• High levels of fantasy play• More intensity in role play

• Divide into four groups. Each group will take an age range and make a list of what you would expect developmentally from a child in that range- speech, cognitive, social, play behavior.

• Age ranges 0-2, 2-5, 6-11, 12 and up

Communication – Hanen Center

• Discoverers- infants react, communicate to show need, use body language and sounds that can be interpreted as happy or sad.

Communicator (stage 2)

• Communicate with purpose, but without words. Ex: hold arms up to indicate desire to be picked up

• Imitate sounds

First Words• Around 14 months

Combiner• Combine words together. Rapid

growth of vocabulary, fewer gestures

• By age 7 masters most sounds and can read, spell, and write words.

Cognitive Development- Piaget

• Sensory Motor- birth to 18 months• Use senses and motor skills to

explore world• Begin to build and construct

Preoperational• 18 months to 6 years• Use symbols• Pretend play• Role play (may have imaginary

friends) • Begin to understand games with

rules

Concrete Operations • Ages 6-12 • Logical thought• Inductive and Deductive reasoning• Understand rules in games

Formal Operations• Ages 12 and up• Manipulate and organize ideas• Hypothetical thinking• Can imagine the way they want

their world to be and can compare it to present

Play Development• 0-2 body centered, solitary,

imitative, repetitive• 2-3.5 parallel play, toy centered,

exploratory• 3.5-6.5 pretend play, creative, use

body symbolically

• 6-11 Likes games with rules, dramatization, reciprocal, social

• Age 5- all powerful “it” • Age 8 like cooperative games like

Frozen Tag and Red Rover

• 11 and up – like cooperative games, board games

History and Development of Play Therapy

Chapter 3

• First published case was “little Hans”

• Freud saw once, but analyzed him by listening to father’s observations of Han’s play.

• At that time, emotional problems of children were viewed as educational deficiencies.

• 1919 Melanie Klein began to use play for analyzing children. Play was substituted for verbalized free association, which she then analyzed.

• Anna Freud used play to develop an emotional relationship. Interpretation occurred later in the process.

• Both wanted to uncover the past and strengthen the ego.

• Klein used interpretation and symbolic meaning. Each child had a drawer for his/her toys.

Release Play Therapy• 1930’s- David Levy• Believed in abreaction effect of

play• Re-enact trauma to release pain

and tension.

Relationship Play Therapy

• 1930’s Jesse Taft and Frederick Allen• Evolved from work of Otto Rank.• Focus on here and now• And curative power of the emotional

relationship between child and therapist• See children as having inner strength

and capacity to change.

Nondirective/Child-Centered Play Therapy • 1940’s Axline• Student of Rogers. • No effort to control or change the

child• Based on theory that behavior is

caused by drive for self-realization.

• Goal is self-awareness and self-direction

• Child has freedom to play• Therapist reflects thoughts,

feelings and behavior.

Current Trends• Adult play therapy• Group play therapy• Therapy in medical settings• Play therapy with families

Chapter 4View of Children

• Tenets for relating to children:• Children are not miniature adults• Children are people• Children are unique and worthy of

respect• Children are resilient

• Children have an inherent tendency towards growth and maturity

• Children are capable of positive self-direction

• Children’s natural language is play• Children have a right to remain silent• Children will take the therapeutic

experience to where they need to be• Children’s growth cannot by speeded up

Children are resilient

• Can you give some examples

Chapter 5Child-Centered Play

Therapy

• A complete therapeutic system, not just the application of a few rapport-building techniques, and is based on a deep and abiding belief in the capacity and resiliency of children to be constructively self-directing.

Role of Play Therapist• Relate to the child in ways that will

release the child’s inner-directional, constructive, forward-moving creative, self-healing power.

Personality Theory• How a child feels about him or

herself is what makes a significant difference in behavior.

• True also for adults

Structure of Personality• Person- all that a child is-

thoughts, behaviors, feelings and physical being.

• Change in one part results in changes in other parts

Phenomenal Field

• Consists of everything the child experiences- internal and external

• Behavior must always be understood by looking through the child’s eyes.

• Children constantly experience an internal reorganization of thoughts, feelings and attitudes.

Self• Every child exists in a continually

changing world of experience, of which the child is the center.

• Self is totality of perceptions of the child.

• Can only develop sense of self through interactions with others

• Therefore, play therapy provides an atmosphere of acceptance and safety and therapist becomes a significant person in the child’s life, thus, allowing child to see self as capable.

• Best way to understand child’s behavior is from the internal frame of reference of the child.

• See list, pp. 60 of Roger’s Propositions

• Children have directional striving, which occurs spontaneously when the child is ready.

Adjustment/Maladjustment

• The further apart the behavior and the self concept, the greater the degree of maladjustment.

• Incongruence between self concept and experience results in incongruence in behavior.

• Therapist needs to be “real” and genuine.

• For instance, the therapist can expresses own feelings if something the child says or does is uncomfortable.

Warm Caring/ Acceptance

• Therapist must first accept self. • Doesn’t wish the child was

somehow different• Children will pick up on therapist’s

nonverbal communication

Sensitive Understanding

• Perceptions are changed as a result of meaningful relationships

• Therapist is in full emotional contact and tries hard to be fully in tune with all that the child is experiencing and expressing.

• Power to change is within the child• Trust the child• See page 80 for Axline’s list of

principles.

4 Healing Messages of Play

I am here for you!I hear you!I understand you! I care!

Garry Landreth’s “Rules of Thumb”

1) You can’t give away what you don’t possess.2) Be sensitive to how the world is perceived by a

child. Trust the child to take you where he or she needs to go.

3) Listen to the child-use eyes and ears!4) Don’t ask questions to which you already know

the answer.5) What the child believes about him or herself is

more important than what the child knows.6) How the counselor feels about the child is more

important than what the counselor knows about the child.

• See lists on pp. 82 and 83 for therapeutic dimensions

• And page 84 and 85 for objectives and 87 and 88 for learning experiences